Provider Demographics
NPI:1225200983
Name:MICHIGAN PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:MICHIGAN PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDIENT/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:877-647-7924
Mailing Address - Street 1:23810 MICHIGAN AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-1830
Mailing Address - Country:US
Mailing Address - Phone:877-647-7924
Mailing Address - Fax:877-647-7924
Practice Address - Street 1:23810 MICHIGAN AVE
Practice Address - Street 2:STE 201
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-1830
Practice Address - Country:US
Practice Address - Phone:877-647-7924
Practice Address - Fax:877-647-7924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty